Ethnographic study on the community health nursing practices in rural Japan

这项民族志研究的目的是从公共卫生护士的角度描述日本农村的社区卫生护理实践。24名在农村社区工作的公共卫生护士(PHN)参加了非结构化的录音访谈，结果如下：1.农村社区保持了传统的价值观和规范，但农村生活发生了迅速的变化。发现PHN与社区成员之间的关系更为密切。发现了6种具有农村特色的社区卫生护理实践：“从社区整体考虑”、“从实际工作到卫生保健政策规划进行实践”、“创建社区卫生保健体系”、“在个人、组织和机构之间建立网络”、“调查社区实际情况”和“立即实施”。“个人、组织和机构之间的网络”是农村地区最重要的社区卫生护理实践，有五种模式：“与居民联系”、“与其他专业人员或镇(村)所工作人员保持关系”、“与客户及其家人联系”、“在社区开展保健项目时的网络策略”和“在社区内创建居民组织或邻居网络”。社区卫生服务人员在开展社区卫生护理活动时，对社区卫生服务理念、实现目标的满足感、农村社区卫生服务的弊端、居民和社区的正义感、对居民和社区责任的认识、对社区卫生服务的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对农村社区护理工作的认识、对农村社区护理工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对社区卫生服务工作的认识、对农村社区

The purpose of this ethnographic study was to describe the community health nursing practices in rural Japan from public health nurses' perspectives. Twenty-four public health nurses (PHNs) who were working at rural community participated in unstructured, tape-recorded interviews.The findings were as follows:1. Rural communities have maintained the traditional values and norms, while rural life has rapidly changed.2. It was found the closer relationship between PHNs and community members.3. Six characteristic rural community health nursing practices were found; 'considering the whole of community', 'conducting the practices from the actual work to health care policy planning', 'creating the health care systems in a community', 'networking among the persons, organizations and institutions ', 'surveying the actual condition of community' and 'carrying out immediately '.4. 'Networking among the persons, organizations and institutions' which was the most important community health nursing practice in rural areas had five kinds of modes; 'connecting with the residents', 'maintaining the relationship with other professionals or staff members of town (village) office ', 'connecting with clients and their family members', 'networking strategies when PHNs initiate the health care programs' and 'creating the residents' organizations or neighbors' networks in a community'.5. PHNs were practicing community health nursing activities with the cognitions such as 'philosophy of community health nursing practices', 'a sense of satisfaction to attain the aim', 'disadvantages of PHNs working at rural community ', 'a sense of justice for residents and their community', 'awareness of PHN's responsibilities for residents and theft community' and 'desire to learn and improve the health care of one's community'.From these results, it seems important to clarify the knowledge about rural community health nursing practices and create the rural nursing modal.